Flovent (fixotide) inhalers and pred

Hi All and HNY!

I ASKED THIS BEFORE..SORT OF, BUT, THE ANSWERS WERE NOT MATCHING WHAT I AM SEEING

BERT, HAS BEEN ON PRED FOR AT LEAST SIX MONTHS FOR ASTHMA RELATED PROBLEMS. SO, DESPITE MY VETS OBJECTIONS I PUT HIM 250 FIXOTIDE (1) PUFF BID. AFTER TWO WEEKS I STARTED CUTTING BACK THE PREDSISOLONE AS I CONTINUE TO DO. HOWEVER, IS BGs ARE HIGH AND DIFFICULT TO CONTROL DISPITE THE DROP IN PRED DOSING. FLOVENT (AN INHALED STEROID) IS NOT SUPPOSED TO RAISE BGs BECAUSE MOST OF IT STAYS IN THE LUNG.

THE ONLY THING DIFFERENT THAT I HAVE DONE IS GIVE HIM CHICKEN OR TURKEY BABY FOOD AS A TREAT FOR HIS SHOTS AND INHALED THERAPY. IT'S BEECHNUT "1" WHICH SAYS "0" CARBS ON THE LABEL. HE GATS ABOUT A JAR A DAY.

I FRUSTRATED AND CONCERNED HE IS SATYING SO HIGH.

THANK YOU FOR READING THIS AND YOUR VALUED ADVICE.

 

My experience with asthma/diabetes

With Clouseau (GA) was that if his asthma was flared up, his BG stayed higher than when he was more stable. The Flovent never seemed to affect his BG values at all- BUT, if I had to administer the rescue inhaler (albuterol), it would lead to a fast rise in BG (sometimes more than 50 pts) that would last for 4-5 hours.

It took somewhere around 3 months for Clou's asthma to stabilize on the Flovent (2 puffs 220 BID, not once daily as you are doing- so I would recommend that you adjust to 1 puff am & pm while you decrease pred instead of SID). I think once Bert's asthma is under control, his diabetes should also start to regulate.

I know how frustrating it can be to juggle muliple issues- so remember to be patient and give the meds time to do their job.

 

Just to add, the baby food is fine. It's a 0 carb product.

I give Sydney 1-2 puffs (depending) BID.

 

Is he still on some pred? It sounds like it and if so it is probably still affecting things. Do you have a spreadsheet?

 

Thanks everyone

At present he gets 1/2 tab (2.5mg) daytime and 1/4 tab (1.25mg in the evening) In a few days I will be cutting the daytime dose in half anf continue from there.

He presently gets 220 (1) puff in the day and 220 (1) puff at night.

Thank you all for your insite and advice. I will try doing (2) puffs per teatment, but, I have to struggle with him as it is for (1). I will try and work him up to it.

 

Okay- so he is already getting BID (twice daily) dosing of the flovent? Didn't catch that in your first post, sorry!

How is his breathing? Is the asthma still flaring up (coughing, gagging, heavy abdominal breathing, wheezing, etc...)- or is he currently stable? I ask because if he is NOT stable currently, you will want to wean off the pred much more slowly than you are currently. It takes a couple of weeks for the flovent to "kick in", at least in my experience, so you do not want to wean off the pred before the flovent is working. If his asthma is severe, the dosage of flovent needed to obtain (and keep) stabilization could very well be 2 puffs 220 BID- cats w/ milder asthma may do well on smaller doses. Clouseau was a severe asthmatic, and needed high doses to stay stable.

I hear you on the struggling- it took both my husband and myself to dose Clou when we first started inhaled, one to try to restrain him and the other to hold the mask to his face. I thought it would NEVER get better, but once he stabilized I could just call him to come get his meds and he'd purr during admin. It took about 3 months to be able to medicate him solo, but after that it just got easier and easier.

 

Hi George

If I understand you correctly, you're saying that Bert has been unregulated for the past 6 months and continues to have high BGs despite the reduction in pred? So it's not that you think the Flovent is making his BGs higher, but rather that the reduction in pred hasn't helped regulation? If this is the case, it may be more of a matter of insulin dosing. His diabetes will have to be regulated more closely regardless of his drug regimen.